A Pinch Test to Correct an Unfolded Helix: An Innovative and Predictable Technique
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I N N OV A T I V E T E C H N I QU E S
FACIAL SURGERY
A Pinch Test to Correct an Unfolded Helix: An Innovative and Predictable Technique Jesus Olivas-Menayo1 • Cristina Gomez-Martinez de Lecea2
Received: 12 August 2020 / Accepted: 4 October 2020 Ó Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2020
Abstract The unfolded helix is an ear deformity more frequent than expected. It might be presented alone or combined with other scapha or concha anomalies, giving the appearance of big and prominent ears. Currently, there are few reports published about its restoration and few modifications have been made to its original surgical approaches since the 1970s. The technique herein described aims to facilitate the helix rim restoration procedure by considering the following preoperative and surgical advices. The preoperative use of the pinch test allows to better understand the patients’ expectations, helps to explain the future outcomes to them and simplifies the marking of the tissue to be removed. The additional bilateral only-cartilage resections and the maintenance of the skin excess permit to optimize the cosmetic outcomes. This innovative surgical approach for the helix rim restoration is reliable, has little morbidity associated and presents consistent effective results. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Keywords Ear surgery Unofolded helix Pinch
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00266-020-02011-7) contains supplementary material, which is available to authorized users.
Operative Technique
& Jesus Olivas-Menayo [email protected] 1
FEMM Cirugı´a y Medicina Este´tica, Calle Vela´zquez 22, 18, 28001 Madrid, Spain
2
Department of Plastic and Reconstructive Surgery, Clinica Universidad de Navarra, Avenida Pio XII, 36, Pamplona, Spain
Introduction Ear surgery is one of the most prevalent procedures in plastic surgery [1]. Although correction of prominent ears is the most frequent demanded operation, other ear abnormalities in contour and/or in size are found more often than expected. Hunter and Yotsuyanagi published a modification of the classic Weerdas classification [2], dividing the ear’s anomalies into three grades of dysplasia from lowest to highest degree of severity [3]. Grade I anomalies include minor variations such as macrotia or shape alterations of the cartilage, the lobule and the tragus. Within this group, the absence of the helical overhang, also known as flat helix [4] or shell ear [5], is the most frequent pathology of the helical rim. However, there are few reports published about its correction. The purpose of this paper is to present a new very predictable technique which simplifies the flat helical rim restoration for both exp
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